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JMRX, LLC
SCH040047-00 FIVE RIVERS MEDICAL CENTER
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Covered Entity Details
Entity Name
FIVE RIVERS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH040047-00
Entity Address
2801 MEDICAL CENTER DRIVE
POCAHONTAS, AR 72455
Medicare Provider Number
040047
Participating Start Date
4/1/2021
Last Recertification Date
8/29/2022
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
JMRX, LLC
Pharmacy Address
JMRX LLC DBA RANDOLPH COUNTY DRUG
567 HIGHWAY 67 S STE A
POCAHONTAS, AR 72455
Pharmacy Comments
Contract Details
Approval Date
4/11/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Joey Radcliff, CFO
(870) 892-6204
Contract Pharmacy Representative
Randolph County Drug
Joey Robbins, Pharmacist
(870) 202-2536
Signed By Date
4/11/2018
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